What potential issue arises from incorrect bundling of services, and what might that lead to?

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Multiple Choice

What potential issue arises from incorrect bundling of services, and what might that lead to?

Bundling rules determine when multiple services are paid together versus paid separately. If those rules are applied incorrectly, the claim can be billed at a higher or lower amount than what was actually provided. That means upcoding—charging for a more complex or higher-valued service than performed—or underpayment—missing or underpaying for services that should have been paid separately. In Resolute, incorrect bundling can affect reimbursement, trigger payer audits, and create compliance risk, since payers expect bundling to reflect the true mix of services performed. The idea is that bundling isn’t just a paperwork detail; it directly shapes how much is paid and whether the claim stands up to review.

Bundling rules determine when multiple services are paid together versus paid separately. If those rules are applied incorrectly, the claim can be billed at a higher or lower amount than what was actually provided. That means upcoding—charging for a more complex or higher-valued service than performed—or underpayment—missing or underpaying for services that should have been paid separately. In Resolute, incorrect bundling can affect reimbursement, trigger payer audits, and create compliance risk, since payers expect bundling to reflect the true mix of services performed. The idea is that bundling isn’t just a paperwork detail; it directly shapes how much is paid and whether the claim stands up to review.

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